Separating the Haves from the Have-Nots: State Options for Targeted Application of Hospital Affordability Policies 

Abstract

As states seek to tackle high commercial health care spending, high spending growth, and increasingly unaffordable care, they must consider hospital spending and prices as major contributors. In many states, policy discussions have been stymied by hospitals and their lobbyists, who argue that hospitals are struggling financially and that state action to address hospital prices will result in hospital closures and service line cuts, endangering patient access. This report describes how states can focus affordability efforts to impact highly resourced hospitals and health systems (the haves) without endangering those that would struggle to implement state commercial market affordability policies (the have-nots). It also provides options to help states identify hospitals within each group, using existing public analyses and state data where available.